Provider Demographics
NPI:1780857177
Name:TEXAS LAPAROSCOPIC CONSULTANTS, LLP
Entity Type:Organization
Organization Name:TEXAS LAPAROSCOPIC CONSULTANTS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CIOLLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-493-7700
Mailing Address - Street 1:5115 FANNIN ST.
Mailing Address - Street 2:SUITE 950
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-5898
Mailing Address - Country:US
Mailing Address - Phone:713-493-7700
Mailing Address - Fax:281-971-4065
Practice Address - Street 1:5115 FANNIN ST.
Practice Address - Street 2:SUITE 950
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-5898
Practice Address - Country:US
Practice Address - Phone:713-493-7700
Practice Address - Fax:281-971-4065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3813208600000X
TXM2217208600000X
208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX74RDOtherBLUE CROSS BLUE SHIELD